A specialty insurance underwriter based in New York that serves contractors and construction industry risks has filed a federal racketeering lawsuit against a Manhattan personal injury law firm and dozens of healthcare providers, accusing them of orchestrating a large-scale insurance fraud scheme involving fabricated construction site injuries and sham medical procedures.
The 162-page complaint, filed under the Racketeer Influenced and Corrupt Organizations Act (RICO), represents the fifth such lawsuit initiated since March 2024 by Roosevelt Road Specialty and its reinsurance affiliate, Tradesman Program Managers. These suits collectively target various legal and medical entities operating in the New York metropolitan area.
The latest lawsuit, submitted on June 16 in the U.S. District Court for the Eastern District of New York, names William Schwitzer & Associates, P.C., its founders William Schwitzer and Giovani Merlino, as well as a broad network of doctors, chiropractors, and other medical professionals. The suit claims the defendants collaborated in a coordinated effort to recruit construction laborers—many allegedly undocumented immigrants—to either fabricate or exaggerate injury claims from job-site incidents. These individuals were allegedly funneled into specific medical facilities known to participate in the scheme, where they underwent unnecessary, and at times invasive, procedures intended to inflate personal injury and workers’ compensation claims.
According to the court filing, this fraudulent operation has been active since at least 2018, with a sharp uptick beginning in 2020.
Among the named defendants are 30 medical offices specializing in fields such as orthopedics, diagnostic imaging, pain management, and acupuncture. Notably, 10 of these practices—including Brooklyn Medical Practice, Sayeedus S. Salehin, M.D., Big Apple Pain Management, PLLC, North Shore Family Chiropractic, P.C., and Advanced Orthopedics and Joint Preservation, P.C.—are alleged to have operated from a single location at 410 Ditmas Avenue in Brooklyn. The site is described in the suit as a centralized hub for illicit referrals and fraudulent treatments.
“This legal action exposes a calculated plot that preyed on vulnerable workers and cost insurance companies millions,” said Daniel Hickey Jr., CEO of Tradesman.
The complaint further alleges the involvement of unidentified individuals who served as recruiters, convincing construction workers to take part in staged incidents at worksites throughout New York. Once the claims were initiated, the Schwitzer firm and others allegedly directed participants to compliant medical providers, who would then generate paperwork to support the false claims. These documents were subsequently submitted as part of workers’ compensation and general liability cases, aiming to collect reimbursement for medical bills, lost wages, and settlement demands.
Due to the stringent requirements of New York’s workers’ compensation framework and labor laws, the lawsuit claims these fraudulent claims were often successful.
Additional Legal Actions
Earlier this year, in January, Roosevelt Road and Tradesman filed a similar RICO lawsuit against a different law office—the Liakas Firm—and its managing attorney, Dena Liakas. Three other lawsuits have also been filed in 2024 targeting related actors.
Roosevelt Road and Tradesman aren’t the only ones pursuing legal remedies against these alleged fraud rings involving attorneys and healthcare providers.
For instance, Uber Technologies Inc. launched a racketeering case earlier this year against multiple law firms, medical doctors, and pain clinics, accusing them of orchestrating fake auto accidents and performing unnecessary medical procedures to exploit New York’s no-fault insurance system.
Meanwhile, American Transit Insurance Co. (ATIC)—the state’s largest taxi insurer, which is currently facing severe financial and regulatory scrutiny—filed a lawsuit demanding over $450 million from healthcare providers it alleges participated in a wide-ranging fraud scheme.
In yet another 2024 case, captive insurer Ionian RE, along with three construction companies, alleged a broad-based conspiracy involving staged jobsite injuries and fraudulent claims for workers’ compensation and personal injury. That suit also identifies several law firms—including William Schwitzer & Associates, P.C.; Subin & Associates, LLC; Wingate, Russotti, Shapiro, Moses & Halperin, LLP—as alleged co-conspirators, along with their affiliated runners and a dozen clients who are reportedly linked by familial or personal relationships.